Trephine for corneal grafting



June 10, 1958 A. ARA

' TREPHINE FOR CORNEAL 'GRAFTING Filed Jan. 11, 1956 FIG.

FIG. 2

INVENTOR.

Y ABIDIN ARA ATTORNEYS 'rnnrnnun non coRsuAr. GRAFTING Abidin Ara,Ankara, Turkey, assignor to George P.

Pilling & Son Company, Philadelphia, Pa., :1 corporation of PennsylvaniaApplication January 11, 1956, Serial No. 558,545

6 Claims. (Cl. 128-310) This invention relates to atrephine for cornealgrafting adapted for the cutting and removal of a portion of a cornea tobe transplanted and to cut an opening of a proper size in the cornea towhich transplanting is effected.

It is the general object of the present invention to provide a trephinewhich may be readily and accurately manipulated by a surgeon. In theattainment of this general object there are provided associated elementspermitting a systematic mode of manipulation which will become moreapparent from the following description read in conjunction with theaccompanying drawings in which:

Figure l is a side elevation, partly in section, illustrating apreferred embodiment of the invention;

Figure 2 is an end view of the same; and

Figure 3 is a fragmentary elevation showing graduations utilized forindicating the depth of a cut.

The trephine comprises a body 2 which has the form of a surface ofrevolution providing a narrow neck portion 4 which is knurled. asindicated at 6, the body 2 having fiat portions 8 provided on oppositesides thereof, which portions are also desirably knurled to provide forsecure gripping, in conjunction with the neck portion 4, by the surgeonsfingers. The body 2 is provided with a central bore 10 and hasextensions 12 and 14 which are slotted at 16 and 18 to receive screws 20and 22 projecting from a head 24 in which is secured a rod 26, the head24 being secured in adjusted axial position by means of the knurled nuts28 and 30 which effect clamping in association with the extensions 12and 14.

The rod 26 is provided at its active end with a spherical socket portion32' having a radius corresponding to that of a cornea. This radius mayvary somewhat in diiferent instruments depending upon the radius of thecornea to be operated upon. A countersink 34 communicates with a bore 36extending axially through the rod 26, the other end of the rod beingprovided with annular projections 40 onwhich may be secured a rubberbulb 38, or alternatively, a tube leading to a suction producing means.

Surrounding the rod 26 and located within the bore 10 for slidablemovement is a sleeve 42 forming the trephining knife and for thispurpose provided with an external taper forming a sharp cutting edgeindicated at 44. The sleeve 42 must slide freely on the rod 26 and forthis purpose it desirably has its guiding engagement with the rod onlyat the ends thereof, the major portion of the length of the rod being ofreduced diameter as indicated at 46 to minimize friction.

At its inner end the sleeve 42 is secured in a circular heat 48 which isknurled and provided with a groove 50 the position of which may be readagainst a scale 51, graduated, for example, in half millimeters providedon the edge of the body extension 12 as indicated in Figure 3. The headmay beprovided with indices to facilitate measurements to, for example,0.1 mm. The

head 48 is threaded at 52 for reception in a nut member cutting blademay be 5.5, 6.5 and 8 millimeters.

ice

54 which is provided with annular groove 56 for engagement by the nose58 of a latch 60 which is pivoted on a stud 62 in a bracket 64 securedto the extension 14 of the body. A spring 66 surrounds the stud 62 andurges the latch nose into the groove 56. A spring 68 housed in the body2 urges the nut 54 toward the right as indicated in Figure l, but thelatch normally holds the nut in the position illustrated in that figure.The nut 54 is prevented from rotating by engagement within an axial slot72 in the edge thereof of a pin 70 secured in the body 2. The nut 54 isflattened at its opposite sides as indicated at 74 to avoid interferencewith the fingers of the surgeon which engage the flat portions 8 of thebody.

In preparing the trephine for use, the head 48 is adjusted to a zeroposition of the groove 50 with respect to the scale 51 by rotating itwithin the nut 54 which is held in position by the latch 66 and pin 74.The axial position of the rod 26 is then adjusted to bring its operatingend coincident with the knife edge 44. The trephine, sterilized in theusual fashion, may then be placed in contact with the cornea of the eye,the bulb 38 being first pressed and then released to provide suctionwhich will cause the cornea to be engaged tightly with the sphericalsocket 32 of rod 26. By a progressive projection of the knife, involvingback and forth rotational movements of the head 48, the surgeon may thencut into and through the cornea, using the position of the groove 50relative to the scale 51 to judge the extent of penetration which hasoccurred. When the cut is complete, the surgeon'may use his finger totrip the latch 68 with the result that the sleeve 42 will be withdrawnbeyond the end of the rod 26 through movement by the spring 68 of theassembly comprising the tube 42, the head 48 and the nut 54, these partsbeing moved to a position where the head 48 engages the member 24.Desirably the spring 68 is so chosen that the movement thus taking placeis a gentle one to avoid mechanical shock in the instrument. The cornealdisc remains held by suction on the end of the rod 26 and may bedisplaced to a glass plate or the like by pressure on the suction bulb38.

What has just been described is carried out both on the eye from whichthe corneal graft is taken and on the eye to which transplanting is tooccur, in the latter case the operation being for the production of theopening into which the corneal disc is to be transplanted. Thetransplanting of the corneal disc into the eye is accomplished in theusual fashion without the use of the instrument, the transplantinginvolving the usual suturing.

From the foregoing it will be evident that the instrument is Welladapted for the purposes indicated. By reason of its construction it maybe readily taken apart for cleaning and is also adapted to conventionalsterilization procedure.

The instrument may be provided in different sizes for the provision ofdifferent diameters of the cutting blade, for example, convenient insidediameters of the The arrangement which has been described provides cleancut edges and in view of the fact that the taper of the blade is on theoutside of the tube 42 the cutting action provides a tapering of theedge of the cut cornea which aids in holding it in its transplantedposition. The use of the same instrument for both cutting operationsinsures a perfect fit of the transplanted cornea in the socket in whichit is received.

It will be evident that various details of the apparatus may be modifiedwithout departing from the invention as defined in the followingclaims.

What is claimed is:

1. A trephine for corneal grafting comprising a body portion, a cornealholding element mounted in said body portion and provided with a socketand connections for, partial evacuation of the region of the socket, anannular knife surrounding the holding element, and means for projectingthe knife beyond the socket end of said holding element.

2. A trephine according to claim 1 in which the projecting means alsorotates said knife. 7

3. A trephine according to claim 1 provided with means for eflectingquick withdrawal of said knife.

4.. A trephine according to claim 2 provided with means for effectingquick withdrawal of said knife.

5. A trephine according to claim 3 in which the last mentioned meanscomprises a spring and latch.

6. A trephine according to claim 4 in which the last mentioned meanscomprises a spring and latch.

References Cited in the file of this patent UNITED STATES PATENTS OTHERREFERENCES V. Mueller & Co. catalogue, pages 4041.

